This institution does not discriminate in hiring or any other decision on the basis of race, color, sex, citizenship, national origin, ancestry, Vietnam era veteran status, or on the basis of age or physical or mental disability unrelated to the ability to perform the work required. No question on the application is intended to secure information to be used for such discrimination.
I voluntarily give this institution the right to make a thorough investigation of my past employment and activities, agree to cooperate in such investigation and release from all liability or responsibility all persons, companies or corporations supplying such information. I consent to take the physical examination, and such future physical examinations as may be required by this institution at such times and places as the institution shall designate. I understand that an offer of employment may be contingent on passing the physical examination which relates to the essential duties I would be required to perform.
I understand that my employment is at will, and that either party is free to terminate the employment relationship at any time withoutcause. I also understand that my employment may be terminated for any misstatement or omission of fact appearing on this applicationform.
If employed, I will be required to complete an Employment Verification Form (I-9), and within three days show satisfactory evidence of identity and eligibility for employment.
If your availability changes, it is your responsibility to fill in an “Availability Card” indicating the changes. Such changes will be effective, then, for any future employment.
l understand that emergency conditions may require me to temporarily work shifts other than the one for which I am applying and agree to such scheduling change as directed by my department head or the Administrator of this institution.
You are applying for an Employment-at-Will position. Nothing in this application is intended to represent a contract for or a guarantee of employment. This application does not constitute a contract. No statements or representations by any representative of the Center shall be construed to confer a guarantee of employment for any period of time unless said representation is in writing and signed by the administrator and is approved by the Board of Directors ofMorningside Center. The management and Board of Directors at Morningside Center reserve the right to extend or terminate employment at anytime, for any reason, within the bounds of Federal and State employment regulations.
I understand that if 1 am employed I will not have a contract for, nor a guarantee of employment but will be governed by the Employment-at-Will doctrine. I understand that no statements or representations made to me by any representative of Morningside Center shall be construed to infer a guarantee of employment for any period of time unless said representation is in writing and signed by the administrator and has been approved by the Board of Directors ofMorningside Center. I further understand that the management and/or the Board reserves the right to extend or terminate my employment at anytime, for any reason, within the bounds of Federal and State employment regulations.
660.317.5 AN APPLICANT FOR A POSITION THAT HAS CONTACT WITH PATIENTS OR RESIDENTS OF MORNINGSIDE CENTER SHALL:
1. SIGN A CONSENT FORM AS REQUIRED BY SECTION 43.540 RSMO, SO MORNINGSIDE CENTER MAY REQUEST A CRIMINAL RECORD REVIEW.
2. DISCLOSE THE APPLICANT'S CRIMINAL HISTORY. CRIMINAL HISTORY INCLUDES ANY CONVICTIONS OR A PLEA OF GUILTY TO A MISDEMEANOR OR FELONY CHARGE AND SHALL INCLUDE ANY SUSPENDED IMPOSITION OF SENTENCE, ANY SUSPENDED EXECUTION OF SENTENCE, OR ANY PERIOD OF PROBATION OR PAROLE; AND
3. DISCLOSE IF THE APPLICANT IS LISTED ON THE EMPLOYEE DISQUALIFICATION LIST AS PROVIDED IN SECTION 660.315.
I HAVE READ AND UNDERSTAND THE ABOVE QUALIFICATIONS FOR APPLICANTS AS REQUIRED REGARDING CRIMINAL RECORD REVIEW.
In order to permit Morningside Center Nursing Home and Assisted Living Apartments to make a thorough investigation of my background, criminal record (adult or juvenile), health, family, personal habits and reputation for employment with said entity, I hereby release from liability and promise to hold harmless from any liability under any and all possible causes of legal action any and all persons who shall furnish any information or opinions regarding my background, criminal record (adult or juvenile), health, family, personal habits or reputation. The undersigned hereby authorizes any person or legal entity who may be contacted by Morningside Center Nursing Home and Assisted Living Apartments, its officers, agents, or employees to release and transmit to such officers, agents or employees, any information, data, or opinions they may have regarding my background, criminal record (adult or juvenile)health, family, personal entities contacted by Morningside Center Nursing Home and Assisted Living Apartments any and all legal privileges I may have to maintain such information as confidential, including but not limited to the following privileges: Attorney-client, physician-patient, psychotherapist-patient, clergyman-penitent, husband-wife, and accountant-client.
The undersigned further agrees to hold harmless and release from liability under any and all possible causes of legal action Morningside Center Nursing Home and Assisted Living Apartments, the Livingston County Nursing Home District, their officers, agents and employees, for any statements, acts or omissions in the course of their investigation into my backgrounds, criminal record, (adult or juvenile), family, personal habits, and reputation. I further realize that it may be necessary for Morningside Center Nursing Home and Assisted Living Apartments to thoroughly investigate all aspects of my personal background and qualifications and, by applying for employment with Morningside Center Nursing Home and Assisted Living Apartments, expressly waive all of my legal rights and causes of action to the extent that the Morningside Center Nursing Home and Assisted Living Apartments investigation (for purpose of evaluating my suitability or application for employment) may violate or infringe upon those aforementioned legal rights and causes of action of mine.
This release from liability given by me to Morningside Center Nursing Home and Assisted Living Apartments, the Board of Directors of Livingston County Nursing Home District, their officers, employees, agents, and all others as heretofore provided, shall apply to any right of action that might accrue to myself, my heirs, and my personal representatives.
BY SUBMITTING THIS APPLICATION, YOU UNDERSTAND THAT IT WILL BE ELECTRONICALLY FILED AND A PAPER APPLICATION AND SIGNATURES MAY BE REQUIRED. ALL INFORMATION ENTERED IS ACCURATE TO THE BEST OF YOUR KNOWLEDGE. YOU HAVE VIEWED AND ACCEPTED THE PAPER APPLICATION PROIR TO FILLING OUT THE ONLINE APPLICATION.
1700 Morningside Drive
Chillicothe, MO 64601